ࡱ> IKH7 bbjbjUU "87|7|l>>>>,jdR  vZl}$ (ri~ ~~~ ~~~~ }~~}~Z~I  `J#H<>\"|"0R~~APPLICATION FOR SENIOR MEMBER ACTIVITIES (This is an application only!Confirmation of acceptance is required)TITLE OF ACTIVITY  FORMTEXT      2. LOCATION OF ACTIVITY 3. DATE OF ACTIVITY  FORMTEXT        FORMTEXT      LAST NAME, FIRST NAME, MIDDLE INITIAL  FORMTEXT      5. CAP GRADE 6. CAP SERIAL #  FORMDROPDOWN   FORMTEXT      ADDRESS (Street #, City, State, Zip Code)  FORMTEXT      8. TELEPHONE NUMBER  FORMTEXT       9. PREVIOUSLY ATTENDED  FORMCHECKBOX  YES  FORMCHECKBOX  NOCAP DUTY ASSIGNMENT  FORMTEXT      CAP UNIT NAME  FORMTEXT      CAP AERONAUTICAL RATINGS  FORMTEXT       DATE LAST FORM 5:  FORMTEXT       DATE LAST MEDICAL:  FORMTEXT       # HRS PIC:  FORMTEXT       MISSION RATED:  FORMCHECKBOX  YES  FORMCHECKBOX  NOCHARTER NUMBER  FORMTEXT       14. DATE JOINED CAP  FORMTEXT       DUTY APPLYING FOR AT THIS ACTIVITY  FORMTEXT       16. ACFT #  FORMTEXT       TYPE  FORMTEXT        FORMDROPDOWN EMERGENCY SERVICES SPECIALTIES 1.  FORMTEXT       2.  FORMTEXT       3.  FORMTEXT       4.  FORMTEXT      LIST PASSENGERS 1.  FORMTEXT       2.  FORMTEXT       3.  FORMTEXT       4.  FORMTEXT      SPECIAL INFORMATION FOR THIS ACTIVITY  FORMTEXT      REASON FOR WANTING TO ATTEND THIS ACTIVITY  FORMTEXT      MEDICAL INFORMATION  FORMTEXT      REMARKS (Use additional sheet if necessary)  FORMTEXT      APPLICANT SIGNATURE DATE  FORMTEXT      ACTION BY SQUADRON COMMANDER  FORMTEXT      SQUADRON CMDR SIGNATURE DATE  FORMTEXT      REMARKS  FORMTEXT      ACTION BY GROUP COMMANDER  FORMTEXT      GROUP CMDR SIGNATURE DATE  FORMTEXT      REMARKS  FORMTEXT      ACTION BY WING COMMANDER  FORMTEXT      WING COMMANDER SIGNATURE DATE  FORMTEXT       TXWG Form 17a, April 1999 (E) Previous editions will be used.  *,(*>@BLN02FHJTV$j<UjUjTUjUjUjlUjUjtUjUmHnHujU jU>RT.zpp < $If$If & F$Ifi$$Ifl0*04 la $$Ifa$ b(P0X02{{q{e, < t$If & F$If < $If$If & F$Ifi$$Ifl0*04 la $&(Z\prt~    F H \ ^ ` j l   6 8 : H J f h j jUj~Uj UjUjUjUj UjUjUmHnHuj$U jUjU>2Z" n r mccc p$Ifi$$Ifl0*04 la < $If & F < $If$If & F$If   P R f h j t v  X Z n p r | ~      @ B V jL Uj Uj` Uj UjP Uj Ujd Uj UjUmHnHujh U jU? P x   N  pf````$If & F$Ifi$$Ifl0*04 la l < t$If & F < $If < $If  6 h Ltw < $Ifi$$Ifl0*04 la$If & F < $IfV X Z d f r t LNbdfpr 468BD"$bdxjrUjUjUjUjUj$UjUj8UjUmHnHu jUj U?tvFH&u  $If & F  $If < $If & F < $IfZ$$Ifl4*+04 la &(b}  $If & F  $If$If & F$IfZ$$Ifl4Z*+04 laxz|$&^`tvx RThjlvx"`b65jRUjUjfUjUjjUjUjnUjUmHnHu jUjU:(tz  $If & F  $Ifm$$Ifl4Z0*04 la(*^x  $If & F  $IfZ$$Ifl4Z*+04 latz  $If & F  $Ifm$$Ifl4Z0*04 la Rz  $If & F  $IfZ$$Ifl4Z*+04 labm$$Ifl4Z0*04 la / =!"#8$8%tDText1tDText2DText3d MMM yytDText4Df Dropdown1  ColLt ColMajCapt1Lt2LtSFOTFOFOSMCadettDText5tDText6tDText7tDeCheck1tDeCheck2tDText8tDText9vDText10DText11MMM yyyyDText12MMM yyyy|DText130.0tDeCheck3tDeCheck4vDText14DText15MMM yyyyvDText16vDText17vDText18Df Dropdown2CORPPRIVATEvDText19vDText20vDText21vDText22vDText23vDText24vDText25vDText26vDText27vDText28vDText29vDText30DText31d MMM yyvDText32DText33d MMM yyvDText34vDText36DText35d MMM yyvDText37vDText38DText39d MMM yy i0@0 Normal_HmH sH tH <A@< Default Paragraph Font,>@, Title$a$5CJ8 z)*Hpq(Gmn-AOcd}9\'@Yr&:;fz{1Ebwx)=[qr0 00 00 00 0 0 0  0 0 0 00 00 00 00 00 0 0 0 0 0  0 0 0 0  00$ V xb 2  t&(b b  &GWYek-9?O[a} $4HTZq},8>EQW^jpw&28frx 1=Ccou )5;\hnFtFtFtFtS$FtFtFtG$G$FtFtFtFtFtFtG$G$FtFtFtFtFtS$FtFtFtFtFtFtFtFtFtFtFtFtFtFtFtFtFtFtFtFtFt-Text1Text2Text3Text4 Dropdown1Text5Text6Text7Check1Check2Text8Text9Text10Text11Text12Text13Check3Check4Text14Text15Text16Text17Text18 Dropdown2Text19Text20Text21Text22Text23Text24Text25Text26Text27Text28Text29Text30Text31Text32Text33Text34Text36Text35Text37Text38Text39HZ.P~ %Ir-F_x'g2d*]  !"#$%&'()*+,'Xl@b5[?Xq9yDv<o'Yl-@Ob}H[q,?EX^qw&9fy1Dcv)<\o$::Nicholas McLarty2C:\WINDOWS\TEMP\AutoRecovery save of Document1.asdNicholas McLartyBC:\Program Files\Microsoft Office\Templates\CAP Forms\TXWG017A.dotNicholas McLartyBC:\Program Files\Microsoft Office\Templates\CAP Forms\TXWG017A.dotKeith D. Rutherford)C:\My Documents\CAP Documents\CAPF17a.dotIW ; IbA M3B ?ABCDEFGJRoot Entry F r,HLData 1Table(WordDocument"8SummaryInformation(8DocumentSummaryInformation8@CompObjjObjectPool r,H r,H  FMicrosoft Word Document MSWordDocWord.Document.89q